The effects of Tai Chi on fall prevention, fear of falling and balance in older people: A meta-analysis

Logghe, I.; Verhagen, Arianne P.; Rademaker, A.; Bierma-Zeinstra, Sita M A; Rossum, Erik van; Faber, Marjan J.; Koes, Bart W.

doi:10.1016/j.ypmed.2010.06.003

Cited by 132 publications

(93 citation statements)

References 45 publications

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“…8 A meta-analysis of nine studies examining t'ai chi in the management of fall prevention, fear of falling, and balance in older adults concluded that insufficient evidence existed to recommend such an intervention in this context. 19,20 A more recent randomised controlled study in 176 elders, randomised to one of three groups (intensive t'ai chi with cognitive-behavioural strategies, t'ai chi alone and a usual care control group) showed improvements in fear of falling as measured by the Falls Efficacy Scale 13 (FES) in the cognitive strategies group compared with the other two groups. 21 So, although t'ai chi can help to prevent falls in older adults, 22 its role specifically in the management of fear of falling is less clear.…”

Section: Falls and Fear Of Fallingmentioning

confidence: 99%

Cognitive–behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial – the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study

Parry

Bamford

Deary

et al. 2016

Health Technol Assess

122

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BackgroundFalls cause fear, anxiety and loss of confidence, resulting in activity avoidance, social isolation and increasing frailty. The umbrella term for these problems is ‘fear of falling’, seen in up to 85% of older adults who fall. Evidence of effectiveness of physical and psychological interventions is limited, with no previous studies examining the role of an individually delivered cognitive–behavioural therapy (CBT) approach.ObjectivesPrimary objective To develop and then determine the effectiveness of a new CBT intervention (CBTi) delivered by health-care assistants (HCAs) plus usual care compared with usual care alone in reducing fear of falling.Secondary objectives To measure the impact of the intervention on falls, injuries, functional abilities, anxiety/depression, quality of life, social participation and loneliness; investigate the acceptability of the intervention for patients, family members and professionals and factors that promote or inhibit its implementation; and measure the costs and benefits of the intervention.DesignPhase I CBTi development.Phase II Parallel-group patient randomised controlled trial (RCT) of the new CBTi plus usual care compared with usual care alone.SettingMultidisciplinary falls services.ParticipantsConsecutive community-dwelling older adults, both sexes, aged ≥ 60 years, with excessive or undue fear of falling per Falls Efficacy Scale–International (FES-I) score of > 23.InterventionsPhase I Development of the CBTi. The CBTi was developed following patient interviews and taught to HCAs to maximise the potential for uptake and generalisability to a UK NHS setting.Phase II RCT. The CBTi was delivered by HCAs weekly for 8 weeks, with a 6-month booster session plus usual care.Main outcome measuresThese were assessed at baseline, 8 weeks, 6 months and 12 months.Primary outcome measure Fear of falling measured by change in FES-I scores at 12 months.Secondary outcome measures These comprised falls, injuries, anxiety/depression [Hospital Anxiety and Depression Scale (HADS)], quality of life, social participation, loneliness and measures of physical function. There were process and health-economic evaluations alongside the trial.ResultsFour hundred and fifteen patients were recruited, with 210 patients randomised to CBTi group and 205 to the control group. There were significant reductions in mean FES-I [–4.02; 95% confidence interval (CI) –5.95 to –2.1], single-item numerical fear of falling scale (–1.42; 95% CI –1.87 to 1.07) and HADS (–1; 95% CI –1.6 to –0.3) scores at 12 months in the CBTi group compared with the usual care group. There were no differences in the other secondary outcome measures. Most patients found the CBTi acceptable. Factors affecting the delivery of the CBTi as part of routine practice were identified. There was no evidence that the intervention was cost-effective.ConclusionsOur new CBTi delivered by HCAs significantly improved fear of falling and depression scores in older adults who were attending falls services. There was no impact on other measures.Further workFurther work should focus on a joint CBTi and physical training approach to fear of falling, more rational targeting of CBTi, the possibility of mixed group and individual CBTi, and the cost-effectiveness of provision of CBTi by non-specialists.Trial registrationCurrent Controlled Trials ISRCTN78396615.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 56. See the NIHR Journals Library website for further project information.

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Section: Falls and Fear Of Fallingmentioning

confidence: 99%

Cognitive–behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial – the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study

Parry

Bamford

Deary

et al. 2016

Health Technol Assess

122

View full text Add to dashboard Cite

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“…En relación con la mejora del equilibrio existen otro tipo de programas entre los que se destaca el Tai-Chi y aquellos que integran componentes físicos y cognitivos, representando un valor añadido al compararlos con programas que establecen su principal foco en lo físico (26). Esta disciplina presenta un efecto positivo sobre el miedo a caerse y el equilibrio frente a los que solo se han aplicado ejercicios (26), y si bien la evidencia del efecto del Tai-Chi sigue siendo poco clara (26), algunos estudios que emplean esta técnica (27,28) obtienen un efecto en la prevención de caídas al mejorar el equilibrio, la flexibilidad y la reducción del miedo a caer.…”

Section: Resultsunclassified

Effectiveness of an Intervention to Reduce the Fear of Falling in Elderly Persons

Meléndez-Moral¹,

Garzón-Soler²,

Sales³

et al. 2014

Aquichan

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Objetivo: las caídas y el miedo a caerse se relacionan entre sí, siendo cada uno de ellos factor de riesgo del otro. Este trabajo pretende analizar la efectividad de una intervención para reducir el miedo a caer y sus consecuencias dado que la aplicación de este tipo de tratamientos ha mostrado resultados satisfactorios. Método: mediante un diseño cuasi-experimental, con medidas pre-pos, se evaluó a 53 sujetos, con edades comprendidas entre 65 y 89 años y que habían sufrido una caída anterior. La muestra fue dividida en grupo control y tratamiento, poniéndose en marcha un método combinado de ejercicios y educación sanitaria para la prevención de caídas. Resultados: se obtuvieron resultados significativos en la calidad de vida relacionada con la salud, el equilibrio y el miedo a caer, observándose mejoras en el grupo tratamiento. Conclusión: la aplicación de intervenciones para la reducción del miedo a caerse en población anciana se plantea como un tratamiento cuyos efectos serían dobles, pues no solo se reduciría el propio miedo sino que, dada la asociación existente, se reduciría la posible caída por repetición.

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“…Mesmo os autores que não encontraram evidências da eficácia do TCC na estabilidade postural, 16 no equilíbrio, na RA e na força, 17 reconhecem que há diminuição na incidência de quedas e no medo de cair nos idosos praticantes dessa modalidade de exercício. Embora Logghe et al 18 argumentem que a melhora da CF com a prática do TCC aplica-se somente aos idosos frá-geis institucionalizados, nossos achados não são concordantes com essa afirmação. Nossa amostra foi constituída por idosos vivendo na comunidade, com alto nível de independência no desempenho das AVDs.…”

Section: Capacidade Funcionalunclassified

Tai Chi Chuan melhora funcionalidade e qualidade de vida em homens idosos com baixa densidade mineral óssea

Pereira¹,

Souza²,

Paula³

et al. 2017

Geriatr., Gerontol. Aging

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a RESUMOOBJETIVO: Avaliar efeitos do Tai Chi Chuan (TCC) na capacidade funcional (CF) e na qualidade de vida (QV) de homens idosos com baixa densidade mineral óssea (DMO). MÉTODO: Estudo quasi-experimental, controlado, cego, com 41 idosos (≥ 60 anos) divididos em dois grupos: grupo experimental -G1 (TCC; n = 20; 69,2 ± 6,2 anos) e grupo controle -G2 (controle; n = 21; 69,0 ± 5,7 anos). A DMO (coluna lombar e colo do fêmur) foi avaliada com raios-x de dupla energia (DEXA). Para aferir CF foram utilizados: testes de resistência aeróbia (RA); de força e flexibilidade de membros superiores e inferiores; de equilíbrio em condições estática, dinâmica e funcional; e de alcance funcional, assim como para risco de quedas. A QV foi pesquisada pelo questionário SF-36 (MOS 36 ltem Short-Form Health Survey). O G1 praticou TCC estilo Yang, com 24 movimentos por 12 semanas, 2 vezes por semana, em intensidade leve; o G2 não praticou atividade física orientada. RESULTADOS: Praticantes de TCC apresentaram valores significativamente maiores em resistência aeróbia, em força de membros superiores e inferiores, e para equilíbrio dinâmico. Ao aferir a QV, surgiu significância para escore total, assim como para as dimensões de capacidade funcional, estado geral de saúde, vitalidade e saúde mental. DISCUSSÃO: Constataram-se efeitos benéficos do TCC em CF e QV, o que agrega evidências à sua utilização em homens idosos com baixa DMO. CONCLUSÃO: O TCC é eficaz na melhora da CF e da QV em homens idosos com baixa DMO. PALAVRAS-CHAVE: tai chi chuan; idoso; osteoporose; qualidade de vida. ABSTRACT OBJECTIVE:The purpose was to assess the effect of Tai Chi Chuan (TCC) on functional capacity (FC) and quality of life (QoL) in elderly men with low bone mineral density (BMD). METHODS: This quasi-experimental, controlled blinded trial evaluated 41 senior men (≥ 60 years), divided into two groups: control group 1 -G1 (TCC; n = 20; 69.2 ± 6.2 years) and control group 2 -G2 (control; n = 21; 69.0 ± 5.7 years). The BMD (of lumbar spine and femur neck) was assessed by dual energy x-ray absorptiometry (DEXA). FC was assessed for aerobic endurance, for upper and lower limbs strength and flexibility, for static, dynamic and functional balance testes, and for risk of falls. QoL was assessed by the SF-36 questionnaire (MOS 36-item Short-Form Health Survey). G1 practiced the 24-form Yang style of TCC, for 12 weeks twice a week on low intensity; G2 did not practice oriented physical activity. RESULTS: TCC practitioners had significantly higher scores for aerobic endurance, upper and lower limbs strength, and dynamic balance. In terms of QoL, values were significantly better in total score and aspects such as FC, general health, vitality, and mental health. DISCUSSION: TCC was proven beneficial to FC and QoL scores, which adds evidence for its practice by elderly men with low BMD. CONCLUSION: TCC training is effective in improving FC and QoL in elderly men with low BMD.

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The effects of Tai Chi on fall prevention, fear of falling and balance in older people: A meta-analysis

Cited by 132 publications

References 45 publications

Cognitive–behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial – the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study

Cognitive–behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial – the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study

Effectiveness of an Intervention to Reduce the Fear of Falling in Elderly Persons

Tai Chi Chuan melhora funcionalidade e qualidade de vida em homens idosos com baixa densidade mineral óssea

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